Preventive Effect of Different Doses of Tramadol on Postoperative Shivering during and after Lower Limb Orthopedic Surgery under Spinal Anesthesia as Compared to Control Group

Document Type : Original Article (s)

Authors

1 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Postoperative shivering is a common complication of surgical procedures under spinal anesthesia. The aim of this study was to determine the preventive effect of different doses of tramadol injection on shivering during and after lumbar orthopedic surgery under spinal anesthesia as compared to control group.Methods: In a clinical trial study, 128 patients underwent lower limb orthopedic surgery in 4 groups of 32 patients received 0.5, 0.75, and 1 mg/kg, tramadol and normal saline with equal volume, 5 minutes before spinal anesthesia. The incidence of postoperative shivering was compared in four groups.Findings: A total of 11 patients suffered from postoperative shivering, 1 (6.2%), 2 (1/5), and 1 (2.6%) received tramadol 0.5, 0.75, and 1 mg/kg, respectively, and 7 (17.9%) were of the control group. The incidence of shivering in the control group was significantly higher than other groups (P = 0.021).Conclusion: In this study, all three doses of 0.5, 0.75, and 1 mg/kg of tramadol were effective in preventing postoperative shivering, but the dose of 1 mg/kg was more effective. Therefore, a dose of 1 mg/kg tramadol seems to be a more appropriate dose for controlling postoperative shivering.

Keywords

References

  1. Hidayah MN, Liu CY, Joanna OS. Ketamine and tramadol for the prevention of shivering during spinal anaesthesia. Clin Ter 2014; 165(4): 193-8.
  2. Bansal P, Jain G. Control of shivering with clonidine, butorphanol, and tramadol under spinal anesthesia: a comparative study. Local Reg Anesth 2011; 4: 29-34.
  3. Shukla U, Malhotra K, Prabhakar T. A comparative study of the effect of clonidine and tramadol on post-spinal anaesthesia shivering. Indian J Anaesth 2011; 55(3): 242-6.
  4. De WJ, Sessler DI. Perioperative shivering: physiology and pharmacology. Anesthesiology 2002; 96(2): 467-84.
  5. Sessler DI, Ponte J. Shivering during epidural anesthesia. Anesthesiology 1990; 72(5): 816-21.
  6. Sessler Daniel I. Temperature monitoring. In: Millar RD, editor. Textbook of Anaesthesia. 5th ed. New York, NY: Churchill Livingstone; 1994. pp. 1367-89.
  7. Dal D, Kose A, Honca M, Akinci SB, Basgul E, Aypar U. Efficacy of prophylactic ketamine in preventing postoperative shivering. Br J Anaesth 2005; 95(2): 189-92.
  8. Kranke P, Eberhart LH, Roewer N, Tramer MR. Pharmacological treatment of postoperative shivering: a quantitative systematic review of randomized controlled trials. Anesth Analg 2002; 94(2): 453-60.
  9. Mahesh T, Kaparti L. A randomised trial comparing efficacy, onset and duration of action of pethidine and tramadol in abolition of shivering in the intra operative period. J Clin Diagn Res 2014; 8(11): GC07-GC09.
  10. Mahesh T, Kaparti L. A randomised trial comparing efficacy, onset and duration of action of pethidine and tramadol in abolition of shivering in the intra operative period. J Clin Diagn Res 2014; 8(11): GC07-GC09.
  11. Zahedi H. Comparison of tramadol and pethidine for postanesthetic shivering in elective cataract surgery. J Res Med Sci 2004; 9(5): 235-9.
  12. Mohta M, Kumari N, Tyagi A, Sethi AK, Agarwal D, Singh M. Tramadol for prevention of postanaesthetic shivering: a randomised double-blind comparison with pethidine. Anaesthesia 2009; 64(2): 141-6.
  13. Katyal S, Tewari A, et al. Shivering: Anesthetic considerations. J Anaesth Clin Pharmacol 2002;18:363-376.
  14. Wason R, Jain N, Gupta P, Gogia AR. Randomized double-blind comparison of prophylactic ketamine, clonidine and tramadol for the control of shivering under neuraxial anaesthesia. Indian J Anaesth 2012; 56(4): 370-5.
  15. Tobi K, Imarengiaye C, Edomwonyi N. Tramadol effects on perioperative shivering in lower limb orthopedic surgeries under spinal anaesthesia. J West Afr Coll Surg 2012; 2(2): 63-79.
Journal of Isfahan Medical School
Volume 36, Issue 489 - Serial Number 489
July and August 2018
Pages 865-871

Files

History

  • Receive Date: 11 April 2018
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics